O R I G I N A L R E S E A R C H
Relationship between study habits and academic
achievement in students of medical sciences in
This article was published in the following Dove Press journal: Advances in Medical Education and Practice
Alireza Khatony 3
1Clinical Research Development Center
of Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran;2Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran;3Health Institute, Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
Purpose:Study habits have been the most important predictor of academic performance and play a special role in the academic achievement of students. The aim of this study was to investigate the status of study habits and its relationship with academic achievement in medical sciences students in Kermanshah-Iran.
Materials and methods: This cross-sectional study was carried out on 380 medical sciences students at Kermanshah University of Medical Sciences. The samples were ran-domly assigned to the study. The Palsane and Sharma study Habit Inventory was the tool used for data collection. Data were analyzed by descriptive and inferential statistics.
Results:The mean of students’grade point average was 15.73±1.5 out of 20 and the mean of total status of study habits was 45.70±11.36 out of 90. The status of study habits in 81.3%
of the students was at moderate level. There was a direct and signiﬁcant relationship between
study habits and academic achievement.
Conclusion:The status of study habits was at moderate level for most students. Therefore,
it is recommended to consider and assess students’study habits at the time of entry into
university, in addition, speciﬁc training should be offered to students in order to help them
learn or modify study habits to increase their academic achievements.
Keywords:academic achievement, student, study habit
Academic performance of students is one of the main indicators used to evaluate the quality of education in universities.1,2 Academic performance is a complex process that is inﬂuenced by several factors, such as study habits.2Study habit is different individual behavior in relation to studying3and is a combination of study method and skill.4In other words, study habits include behaviors and skills that can increase motivation and convert the study into an effective process with high returns, which ultimately increases the learning.5This skill is also deﬁned as any activity that facilitates the process of learning about a topic, solving the problems or memorizing part or all of the presented materials.3 Study habits are in fact the gateway to success and differ from person to person.4
According to previous studies, good study habits include studying in a quite place, studying daily, turning off devices that interfere with study (such as TV and mobile phones), taking notes of important content, having regular rests and breaks, listening to soft music, studying based on own learning style, and prioritizing the Correspondence: Alireza Khatony
Clinical Research Development Center, Imam Reza Hospital, Nurse Blvd., Kermanshah, Iran
Tel +98 833 827 9394 Fax +98 833 827 9394 Email Akhatony@gmail.com
Advances in Medical Education and Practice
open access to scientiﬁc and medical research
Open Access Full Text Article
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difﬁcult contents.6Some of the worst study habits include procrastination, evading the study, studying in inappropri-ate conditions, and loud sound of music and television during studying.7
Study habits are the most important predictor of academic performance and global research has revealed that study habits affect academic performance.8In this regard, medical students are faced with a large amount of information that is difﬁcult to organize and learn, and requires knowledge and application of study skills.5,9Evidence suggests that learners who do not have enough information about study strategies do not attain effective and stable learning, and therefore will not have an appropriate level of academic achievement.3In other words, students with better academic achievement use these skills more than those with lower academic achievement.10
Given the important role of study skills in a student’s academic achievement, today, many prestigious universities such as York University in Canada and University of Berkeley in California teach study skills to newly-enrolled students.11In different studies, study skills and habits and their relationship with students’academic achievement have been studied and different results have been reported.1,3,12 Also, various studies have reported the study habits of stu-dents from weak to desirable levels.5,7,10 In this regard, a study conducted on study habits of students in 21 medical universities in Iran showed that 32% of the students suffered from a severe lack of study skills and habits.10 In many studies, a positive and signiﬁcant correlation has been found between students’ study habits and their academic achievement.4,6,7,10 However, in Lawrence’s study, no sig-niﬁcant relationship was found between these two variables.1 Considering the importance of study skills and habits of students, and the important role they play in the aca-demic achievement of students, and taking into account that study habits vary from person to person and from place to place, and also as the results of related studies are different from each other, the present study was designed and implemented. Our goal was to investigate the relationship between study habits and academic achievement of medical sciences students in Kermanshah University of Medical Sciences (KUMS), Iran.
The present study had a descriptive-analytical and cross-sectional design and was conducted between November 2017 and April 2018.
We sought to answer the following questions: 1) what is the status of students’ study habits in terms of variables such as; faculty, place of study, academic degree, history of probation, status of residence, and gender? 2) what is the status of students’ academic achievement in terms of variables such as; faculty, place of study, academic degree, history of probation, status of residence, and gender? and 3) what is the relationship between the status of study habits and students’academic achievement?
Sample and sampling method
PASS/11 software was used to calculate the sample size. For this purpose, according to the results of Nourian et al's study (2011), in which the highest standard error rate was 0.96,11the minimum sample size was calculated to be 328 individuals with theﬁrst type error of 0.05, and the accu-racy limitation of estimated mean of 1 unit. Considering the 15% probability of not responding, 380 students were enrolled in the study. The samples were selected randomly from different faculties of KUMS, which included the faculties of medicine, nursing and midwifery, dentistry, paramedicine, pharmacology, and health. The sampling classes were formed by the faculties of the university. In each class, proportional to the size of students, numbers of samples were selected randomly using a random table of numbers. Accordingly, the sample size for each faculty was as follows: medical school =130 students, dentistry =20, pharmacology =30, health =50, nursing and midwif-ery =50, and paramedicine =100 students. Inclusion cri-teria included willingness to participate in the study and studying at the second term and above. Exclusion criteria were absence on sampling day and failure to answer all questionnaire questions.
The study tools consisted of individual data collection form and the Palsane and Sharma Study Habit Inventory (PSSHI). The individual information forms included ques-tions about age, gender, marital status, faculty of study, academic degree, history of probation, being native or non-native, and the grade point averages (GPAs) of the previous term(s).
The PSSHI is a standard tool designed by Palsane and Sharma in India (1989)10 and its reliability is higher than that of other study habits questionnaires.13 Validity and reliability of the original version of this questionnaire have
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been conﬁrmed in previous studies.10,14,15Siahi and Maiyo (2015) reported the reliability coefﬁcient of 0.88 for the PSSHI.7 The reliability coefﬁcient of the Persian version of this tool has also been reported as 0.88.10In the current study, content validity analysis was used to determine the validity of the instrument. For this purpose, the question-naire was distributed among 12 panels of experts at KUMS. They were asked to review the questionnaire in terms of ﬂuency, clarity, and relevance. It was then mod-iﬁed based on their opinions. Test-retest method was used to examine the reliability of the PSSHI. In this regard, the questionnaire was distributed among 20 students, and after a 2-week interval, they were asked to answer the ques-tionnaire. Correlation coefﬁcient of the pre-test and post-test scores was 0.87, which was acceptable.
PSSHI has 45 questions and measures the study habits of students in eight areas, including time management (ﬁve items), eg, “I study at a speciﬁc time of the day.”; physical conditions (six items), eg,“I get disappointed by the noise around me.”; learning motivation (six items), eg, “if I do not understand something, I get help from others.”; reading ability (eight items), eg, “before reading the intended chapter, I read its main points.”; note-taking (three items), eg, “I take notes while reading the text.”; memory (four items), eg, “I read some materials without sufﬁcient understanding.”; taking tests (ten items), eg, “before responding to the test questions, I read all the questions ﬁrst.”and health of study (three items), eg, “if the result of the test is not good, I feel disappointed.” Responses are based on a three-option Likert scale that includes: “always or most of the time”,“sometimes”, and “rarely or never” which are graded from two to zero, respectively. Questions 6, 9, 13, 15, 24, 26, 34, 36, 37, 41, and 42 are scored inversely. The score range of the questionnaire is between 0 and 90, and a score of 60 and above reﬂects a desirable level of study habits, a score of 31–60 indicates relatively good or moderate level of study habits, and a score of 30 or below refers to an undesirable level of study habits. The score range for each of the sub-categories is as follows: time management: 0–10; physical conditions: 0–12; learning motivation: 0–12; reading abil-ity: 0–16; note-taking: 0–6; memory: 0–8; taking tests: 0– 20, and health of study: 0–6. The achieved score for each sub-category was computed using the three-part spectrum method. To do this, the lowest score was subtracted from the highest score and the resulting number was divided by 3. The resulting number was the distance of three grades
which indicates the desirable, relatively desirable, and undesirable levels of each sub-category.
To assess academic achievement, the GPA(s) of the previous term(s) was used, which in the Iranian educa-tional system is from 0–20. For this purpose, a GPA of 17 or higher was considered as “good academic achieve-ment”, 14–16.99 as “moderate educational achievement”, and a GPS of less than 13.99 was considered as “poor educational achievement”.
Data collection method
First, permission to conduct the study was obtained from the KUMS Deputy for Research and Technology, and was presented to the authorities of the afﬁliated faculties. In the next step, the list of students in each faculty was taken from the Department of Education and samples from each faculty were selected. Then, according to the classroom schedules, the selected samples were approached and after explaining the purpose of the study to them, a copy of the questionnaire was given to those who agreed to take part in the study. If any of the samples did not want to continue participating in the study, he/she was replaced by a person above or below him/her in the list. The questionnaires were collected by the researcher after completion.
Data were analyzed using 18th version of the Statistical Package for Social Sciences (SPSS v.18.0; SPSS Inc., Chicago, IL, USA). Descriptive and inferential statistics were used to analyze the data. At ﬁrst, Kolmogorov-Smirnov test was used to assess the normality of the data, which showed that academic achievement of students did not have a normal distribution, but the rating of study habits had a normal distribution. Mann–Whitney U test was used to compare academic achievement in terms of dual-mode qualitative variables (such as gender and mar-ital status), and Kruskal-Wallis H test was used to compare academic achievement in terms of multi-mode qualitative variables (such as academic degree and faculty of study). Pearson correlation coefﬁcient was used to evaluate aca-demic achievement in terms of quantitative variables. The
t-test was used to compare the mean of study habits in terms of dual-mode qualitative variables (gender and mar-ital status) and ANOVA was used to compare the mean of study habits in terms of multi-mode qualitative variables (such as academic degree and faculty of study). Pearson correlation coefﬁcient was used to investigate the
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relationship between academic achievement and study
habits. p-values less than 0.05 were considered as
The study was approved by the Ethical Review committee of the Kermanshah University of Medical Science with code: KUMS.REC.1395.292. Objectives of the study were explained to the participants and they were assured about the conﬁdentiality of their information and their responses. Iinformed written consent was also obtained from all participants.
Of the 380 students participating in this study, 65.3% (n=248) were male and 34.3% (n=132) were female. The mean age of the students was 22.26±2.9 years. Most of the students were single (91.1%, n=346), and had no history of probation (92.1%, n=350). The majority of the students were from faculties of medicine (34.2%, n=130) and para-medicine (26.3%, n=100). Most students were studying at doctoral (47.4%, n=180) and undergraduate (45.5%, n=173) levels. They were also mainly native students (59.2%, n=225), (Table 1).
The mean score of students’ study habits was 45.7 ±11.36 out of 90. In terms of study habits, only 10% (n=38) were on a desirable level and 81.3% (n=309) were on a moderate level. Also, 8.7% (n=33) of them were on an undesirable level. In terms of the eight areas of study habits, the status of most students was undesirable in the areas of taking notes (50.2%, n=191) and well-being (48%, n=182), and was desirable in the area of time (27.3%, n=104). The status of most students in the other areas was moderate (Table 2).
The mean of students’ total GPA of the term(s) was considered as an indicator of academic achievement, which was 15.73±1.5 out of 20. The highest and lowest levels of academic achievement were respectively for the students in faculties of health and medicine with a mean and SD of 16.27±1.48 and 15.08±1.39 respectively, which showed a statistically signiﬁcant difference (p<0.001). The highest and lowest levels of academic achievement were respectively related to the MSc and doctoral students with a mean and SD of 16.98±1.61 and 15.19±1.38 respec-tively, which showed a statistically signiﬁcant difference (p<0.001). Academic achievement in students without his-tory of probation was signiﬁcantly higher than those with history of probation with a mean and SD of 15.86±1.42
Table 1Demographic variables and comparison of the academic performance and study habits based on underlying variables
Variables Number (%) Academic achievement Study habits
Mean(SD) p-value Mean(SD) p-value
Gender Female 132(34.7) 16.15(1.34) ***<0.001 46.68(9.91) *†NS
Male 248(65.3) 15.50(1.5) 45.18(12.05)
Marital status Married 34(8.9) 15.57(1.71) ***†NS 43.61(13.38) *NS
Single 346(91.1) 15.74(1.48) 45.91(11.15)
History of probation Yes 30(7.9) 14.20(1.67) ***<0.001 40.33(13.69) *0.007
No 350(92.1) 15.86(1.42) 46.16(11.04)
Place of residence Native 230(60.5) 15.87(1.39) ***0.049 46.98(10.67) *0.009
Non-native 150(39.5) 15.49(1.62) 43.58(12.23)
College of Education Medical 130(34.2) 15.08(1.39) ****<0.001 45.51(10.93) **NS
Dental 20(5.3) 15.87(1.38) 43.20(12.58)
Nursing and midwifery 50(13.2) 16.04(1.36) 48.66(9.63)
Pharmacy 30(7.9) 15.22(1.24) 43.33(9.35)
Paramedical 100(26.3) 16.26(1.48) 44.44(11.66)
Health 50(13.2) 16.27(1.48) 48.20(13.37)
Level of graduation Associate degree 23(6.1) 16.61(1.09) ****<0.001 44.52(11.99) **NS
BSc 173(45.5) 16.14(1.47) 46.44(11.69)
MSc 4(1.1) 16.98(1.61) 57(11.34)
PhD 180(47.4) 15.19(1.38) 44.89(10.87)
Mann-Whitney U test;****
kruskal-Wallis H test;†non-signiﬁcant.
and 14.20±1.67, respectively (p<0.001). Female students had better academic achievement compared to male stu-dents with a mean and SD of 16.15±1.34 and ±15.5±1.5, respectively. This difference was statistically signiﬁcant (p<0.001), (Table 1).
The results showed that, students of the faculty of nursing and midwifery and the faculty of dentistry had the highest and the lowest mean of study habits with mean and SD of 48.66±9.63 and 43.20±12.58 respectively, which was not statistically signiﬁcant. In terms of aca-demic degree, MSc and undergraduate students had the highest and lowest average of study habits, with a mean and SD of 57±11.34 and 44.52±11.99 respectively, which was not statistically signiﬁcant. Students without history of probation had a signiﬁcantly better status of study habits compared to students with probation history (p<0.001), with a mean and SD of 46.16±11.04 and 40.33±13.69, respectively. The results showed that the status of study habits of female students was better than that of male students respectively, with a mean and SD of 46.68±9.91 and 45.18±12.05 respectively, but this difference was not statistically signiﬁcant. Native students had signiﬁcantly better status of study habits compared to dormitory stu-dents (p<0.001), with a mean and SD of 46.98±10.67 and 43.58±12.23, respectively.
Pearson correlation test showed a direct and signiﬁcant relationship between academic achievement and study habits (r=0.235,p<0.001).
In our study, the status of study habits of most students was at moderate level and only one tenth of the students were at the desirable level. Mendezabal (2013), in a study that investigated the study habits of 239 Filipino students, reported their study habits to be at moderate level, which
indicated insufﬁcient and ineffective study skills.12On the other hand, the results of a study conducted on librarian students in Iran indicated the general level of students’ study habits to be 60.5 out of 100.5Although the level of study habits in this study was moderate, this level was higher in our study, which may be due to the differences in the nature of medical sciences and librarian academic programs. In another study that Garner (2013) conducted on 59 undergraduate chemistry students in West Indies, the level of study habits was at desirable level in 59.2% of the students, and this level was poor in the rest.16The differ-ence between the results of this study and our study could be due to the low numbers of participants in Garner’s study and the differences in the tool used to measure study habits, because the tool used in Garner’s study classiﬁed study habits into two good and poor level and eliminated the intermediate level, which might have reduced the accuracy of data and comparative capability of the study.
In our study, in terms of eight areas of study habits, the status of study habits in most students was undesirable in the areas of taking notes and well-being, and was desir-able in the area of time. The status of study habits in most students in the other areas was at moderate level. Regarding the different areas of study habits, the results of studies are varied. In this regard, the result of a study conducted on 150 nursing students in Iran showed that most of the students’ problems were related to taking notes, reading ability, time management, well-being, memory, motivation, learning, physical condition, and taking tests.22 In some studies, time management has been described as one of the major problems for medical students.17,18Mendezabal (2013) also referred to problems such as ineffective time management, lack of planning and concentration, poor study skills, and inadequate examination techniques.12The differences in the
Table 2Frequency of subcategories of students’study habits
Subcategory Undesirable, number (%) Relatively desirable,number (%) Desirable, number (%)
Time 90(23.6) 186(49.1) 104(27.3)
Physical status 50(13.1) 269(70.9) 61(16)
Ability to read 48(12.5) 309(81.4) 23(6.1)
Making notes 191(50.2) 140(37) 49(12.8)
Memory 36(9.4) 278(73.1) 66(17.5)
Learning motivation 61(16.1) 231(60.7) 88(23.2)
Taking tests 28 (7.2) 306(80.6) 46(12.2)
Well-being 182(48) 164(43.2) 34(8.8)
areas of study habits can be attributed to the individual differences between the samples and their previous educa-tional systems.
In our study, the students in the faculties of nursing and midwifery and dentistry had the highest and the lowest mean study habits, respectively. This difference was not statistically signiﬁcant. Despite the fact that this variable has not been discussed in most studies, thisﬁnding reﬂects the relatively similar level of study habits in the students of various medical sciences academic programs.
In our study, there was no signiﬁcant difference between different educational levels in terms of the mean study habits. In other words, the level of study habits in different educational levels was equal. Our results are in
line with the study of Fereydoonimoghadam and
Cheraghian.19 According to the authors of the present article, every student of medical sciences, regardless of what degree level he/she is studying at, should be aware of study skills and habits and how to apply them.
In the present study, students with no history of proba-tion had signiﬁcantly better status of study habits com-pared to the students with a history of probation. Despite the fact that many studies have not addressed this variable, Rezaie and Nourian in their studies, have pointed to a meaningful relationship between probation and poorer academic performance, and have considered study habits as an important factor inﬂuencing these variables.10,11 In this regard, Khan (2016) described poor study habits as the most important reason for students’academic failure.20In our view, students with poor academic performance, by utilizing the proper skills and study habits, can improve their academic performance and thereby prevent the emer-gence of educational problems, such as dropping academic unit/credits and probability of probation.
In our study, the status of study habits in male and female students did not differ from each other signiﬁ -cantly, in other words, in terms of skills and study habits, male and female students were at the same level. Oli (2018), Hashemian (2014), and Torabi (2014) also did not ﬁnd any signiﬁcant difference between the students’ gender and study habits,5,21,22 which can be due to the same educational environment for male and female stu-dents. In our view, every student, whether male or female, should be aware of study skills and habits and use them.
We found that native students had signiﬁcantly better study habits compared to dormitory students. However, some studies did not report statistical signiﬁcance between study habits and place of residence.14In our opinion, the
conditions of place of residence, especially the place of study, play an important role in the study habits of stu-dents. Failure to observe the necessary standards in dormi-tories and the lack of suitable environment and conditions can have a negative effect on students’performance.
We found a positive and signiﬁcant correlation between academic performance and study habits, which is consistent with the results of studies by Fereydoonimoghadam and Cheraghian (2009), Alimohamadi (2018), and Rabia (2017).13,19,23However, Lawrence (2014) and Torabi (2014) did not ﬁnd any signiﬁcant statistical relationship between study habits and academic performance.1,21We believe that the utilization of study skills and habits can play a positive role in improving academic performance of students. Academic achievement and achieving educational goals require the exis-tence of several factors, the most important of which is the study habits of individuals,13 since the use of various and effective methods of study improves academic performance of students. Strengthening each of the eight areas of study skills can help to improve the academic performance of stu-dents, thus it is necessary to pay attention to these areas. Since academic performance is considered as a predictor of success in a person's career, it is important to pay attention to this issue and apply appropriate strategies to improve the study habits of students. Meanwhile, because of the high sensitivity of future professions in medical students, and the need for comprehen-sive learning of the curriculum, paying attention to the status of study habits and its promotion is critically important.
There are some limitations to this study. First, this was a cross-sectional study and according to the nature of cross-sectional studies, it is not possible to determine the causal relationships between study variables. Another lim-itation in this study was related to the data collection method, which was self-reporting. Despite reassuring the samples about the conﬁdentiality of their responses, this approach might have had an impact on the accuracy of our results.
In our study, the academic performance and study habits of most students were at moderate level, which is not satis-factory considering the nature and importance of medical sciences. There was a signiﬁcant relationship between study habits and academic achievement of students. Considering the important role of study habits in academic achievement and future careers of students, and since the majority of study habits can be taught and corrected, it is
recommended that students’ study habits should be
measured at the time of their entry to university, and during their studies, so they can receive training in order to learn or modify study habits. The present study was conducted on students of medical sciences. It is recom-mended that similar studies are conducted on students of other scientiﬁc ﬁelds. Conducting qualitative studies to examine the factors affecting students’ study skills and habits may also be beneﬁcial.
This work was supported by the deputy of research and technology of KUMS (grant number 95306)]. The authors would like to thank the president and co-workers of deputy of research and technology of KUMS, and all the students who patiently participated in our study. We also extend our thanks to the clinical research development center of Imam Reza Hospital afﬁliated to KUMS for their kind help.
The authors report no conﬂicts of interest in this work.
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